Treatment patterns and their outcomes of acute
aortic intramural hematoma in real world:
multicenter registry for aortic intramural
hematoma
- Author(s)
- Yoon-Jung Choi; Jang-Won Son; Sang-Hee Lee; Ung Kim; Dong-Gu Shin; Young-Jo Kim; Seung-Ho Hur; Chang-Wook Nam; Yun-Kyeong Cho; Bong-Ryul Lee; Byung-Chun Jeong; Jin-Bae Lee; Jae-Kean Ryu; Hun-Sik Park; Jang-Hoon Lee; Se-Yong Jang; Jong-Seon Park
- Keimyung Author(s)
- Hur, Seung Ho; Nam, Chang Wook; Cho, Yun Kyeong
- Department
- Dept. of Internal Medicine (내과학)
- Journal Title
- BMC Cardiovascular Disorders
- Issued Date
- 2014
- Volume
- 14
- Issue
- 1
- Abstract
- Background
Intramural hematoma of the aorta (IMH), a variant of classic aortic dissection, shows very dynamic process in the early phase. The aim of this study is to evaluate clinical outcomes of patients with acute aortic IMH from real world registry data.
Methods
We analyzed 165 consecutive patients with acute IMH from five medical centers in Korea. All patients were divided into two groups; type A (n = 61, 37.0%) and type B (n = 104, 63.0%) according to the Stanford classification. Clinical outcomes and morphological evolution by CT were analyzed for 2 years.
Results
Most of the patients (77.0% of type A and 99.0% of type B, P < 0.001) were treated medically during their initial hospitalization. There were no significant differences in in-hospital mortality (4.9% vs. 2.9%, P = 0.671) and 2-year mortality (13.1% vs. 11.5%, P = 0.765) between two groups. During the 2-year follow up period, progression to aortic dissection (18.0% vs. 6.7%, P = 0.037) and surgical treatment (29.5% vs. 2.9%, P < 0.001) were higher in type A. For the type A patients, there were no significant difference in in-hospital mortality (7.1% of surgery vs. 4.3% of medical, P = 0.428) and 2-year mortality (7.1% of surgery vs. 14.9% of medical, P = 0.450) in terms of initial treatment strategy.
Conclusion
For real world practice in Korea, most of IMH patients were treated medically at presentation and showed favorable outcomes. Thus, even in type A acute IMH, early medical treatment with alternative surgical conversion for selected, complicated cases would be a favorable treatment option.
Keywords
Intramural hematoma of the aorta – Survival rates – Treatment
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